Grange Court

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was assessed and that their health, care, wellbeing and communication needs had been assessed and recorded.

During the previous inspection we found the provider did now always effectively assess people’s needs with them and their relatives. At this inspection we found the provider had made improvements and there were clear and up to date assessment completed for people. Relatives we spoke to said they had been involved in assessments of people’s needs. However, people were not always doing activities identified as important to them in their assessments.

The provider did not always deliver people’s care and treatment, including what was important and mattered to them. They did not always follow legislation and current evidence-based good practice and standards

During the inspection we saw leaders and staff were unable to deliver activities that people wanted to do. People were being supported individually, often with 2 or 3 staff with them. However, the staff were made up of a combination of regular and agency staff. This sometimes affected the service’s ability to consistently support people to access their preferred activities. For example, 1 person had been waiting to access an activity of their choice for over a year but had not yet had an opportunity to do the activity. This meant people were not leading valued lives in line with the principles of Right Support Right Care Right Culture.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

We saw permanent staff working well together and directing agency staff to explain how to support people.

Other professionals we spoke to shared that staff and leaders worked well with them to support the people living at Grange Court. Records we reviewed demonstrated positive relationships with professionals the service had worked with to ensure they met the specific needs of people.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. We saw people were supported to engage with medical professionals when required. Leaders had developed a positive relationship with the doctor’s surgery as a result a GP visited people in their home when needed, avoiding trips to the surgery that some people could find distressing.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met the expectations of people and their relatives

People were generally supported to stay safe within their home and local community. However, support plans we reviewed were often restrictive in their approach. Leaders and staff took a risk-averse approach to supporting people, which limited opportunities to try new things or do things differently. This meant leaders could not demonstrate that people were being actively supported to improve their lives or to be exposed to new experiences. We could find no records to show how people were supported to experience new activities which may enhance their lives.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We saw comprehensive documentation that described the lives people lived and the reasons for restrictions imposed on them. These were underpinned by comprehensive assessments and best interest documentation in which the views of a range of people were sought. We saw that the service had gone to lengths to try and ensure people were given the opportunity to understand what was happening to them, or decisions made on their behalf with a range of tools used to do so.